Whether you are trying to build muscle mass or reach your goal weight, keeping track of your progress is an important part of staying motivated. Stefan Arias, FNP-C, from USMD in Fort Worth, Texas, explains how to track your fitness and other preventive health habits you need to know.
May 1, 2024
Docs in a Pod focuses on health issues affecting adults. Providers and partners discuss stories, topics and tips to help you live healthier with hosts Ron Aaron, Dr. Audrey Baria and Dr. Tamika Perry.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Olivia Rahma and former television broadcaster Gina Galaviz will share information to improve your health and well-being. And now here are Gina Galaviz and Olivia Rahma.
GINA GALAVIZ EISENBERG
Welcome to the award-winning Docs in a Pod, presented by WellMed. I'm your host, Gina Galaviz Eisenberg, sitting in today for Ron Aaron, who is on special assignment. We're so pleased to have you with us today. Docs in a Pod is available on podcasts, wherever you get your podcasts. And we're also on the radio in several Texas cities in Texas and Florida.
Each week, we talk about a variety of health and wellness-related issues as they impact Medicare-eligible seniors and others. Our co-host today is nurse practitioner, Olivia Rahma. Olivia, welcome today. You may know if you've been listening for a while now, Olivia works at the WellMed 9th Avenue clinic in St. Petersburg, Florida. She earned her nursing degree at Florida State University in Tallahassee. She then earned her master's degree in nursing at the University of South Florida and Tampa. She's board certified and family practice. She's a competitive show singer so she's our Taylor Swift. Perhaps maybe we can get you to belt out. She's a proud mom of two fur babies, a yellow lab and a golden retriever and she's from the great state of Michigan. Ron probably loves to rub that in since he's from Ohio State. It is great to be here again and exercise is like with weight, right? That's something that patients don't like to talk about, do they?
OLIVIA RAHMA, NP
Oh, yeah, that's one of those topics I bring up and they look at me like, oh, did you really have to ask that?
GINA GALAVIZ EISENBERG
That four-letter word exercise, because we all know exercise is important, but tracking our exercise is probably what would get us on track. That's what we're going to be talking about today with Stefan Arias. Let me just let you know a little bit about him. He obtained his family nurse practitioner degree at the University of Texas at Tyler. He's also board certified by the American Academy of nurse practitioners, and he's always wanted to serve his community. Stefan says that his favorite part about being a primary care provider is the relationships he forms with people. So whether patients want to run a marathon or go fishing with their kids or grandkids, or just make it to the grocery store or church safely, he feels their goals as mutual goals. He likes to do so much with his lovely wife and his family, going out to eat barbecuing, being outdoors and watching Texas A&M football. Welcome to being here with us today Stefan.
STEFAN ARIAS, NP
Howdy, welcome.
GINA GALAVIZ EISENBERG
Howdy, just like a true Aggie. Well, thanks for being here. When patients come in and you ask them how are they doing and you kind of look at their vitals and you say so, you've been exercising? They kind of pause, but you can tell if they're not telling the truth, right?
STEFAN ARIAS, NP
Oh, yeah, I mean, I think kind of like Olivia was saying it is kind of a four-letter taboo topic sometimes. But I do like to kind of make sure that, just like any topic that we talked about in the clinic or in the office, nothing is off topic. We really try to kind of dispel the stigmas around exercise because exercise can be a lot of different things. It doesn't have to be one clear thing for somebody or the way that one person exercises might not be the exact same as the way another person exercises. And it doesn't have to be.
GINA GALAVIZ EISENBERG
I guess patients feel like they don't want to go to the doctor because they don't want to feel judged because they know what they're supposed to be doing, but they can't. How do you get them not to think that way?
STEFAN ARIAS, NP
Man, I think it's definitely creating a relationship with your patients. Sometimes that takes more than more than just one visit, that's for sure. But taking the time to just to kind of sit down and talk to them about what's going on, what their barriers are or what their previous stigmas are surrounding whatever topic it is, whether it's exercise, any other aspect of their health.
GINA GALAVIZ EISENBERG
Olivia, do you feel the same way, do you see that with your patients in Florida?
OLIVIA RAHMA, NP
Oh, for sure. I definitely feel that when I see a patient that's new to me or a new patient in general to the office, it's on my list of questions that I ask about. Your background, your what do you do for work? What kind of diet do you follow? Do you exercise? And I always try to phrase it in a way that I'm not asking because I expect you to tell me one thing. I'm not judging. I tell my patients, I don't expect you to be running a marathon, I'm not running a marathon at all. It's just a way of us for us to get to know you. So the first thing is to realize when your providers are asking you questions, we're not judging you, we're just trying to get to know you and see what your baseline is. One visit a lot of the times it's not going to cut it for building trust.
GINA GALAVIZ EISENBERG
I'm going to ask you how you can get me to start exercising more regularly but before we do that, let me take a moment to let those who may have just joined us know you're listening to the award-winning Docs in a Pod. Our podcast is available wherever you listen to podcasts. By the way, I'm Gina Galaviz Eisenberg sitting in today for Ron Aaron, who is on special assignment. Our co-host is nurse practitioner Olivia Rahma. And our guest is nurse practitioner Stefan Arias, and he's at USMD in Fort Worth, Texas. We're talking about the critical importance of fitness and tracking progress. So your patient walks in, say it's me, and you've checked my blood pressure, maybe it's high. I guess that's the first thing, you know I haven't been exercising if it's high. I try to exercise regularly before I go in so that way my blood pressure is kind of regular and it's usually pretty low. If somebody tells you, yes, I'm exercising. How do you know that they aren't?
OLIVIA RAHMA, NP
Well, you might not know for sure. It's digging a little more so asking, what are you doing for exercise? Then, you can kind of tell. If somebody's telling you I work out four hours a day, and I do XYZ and then everything's coming back. It's like, okay, we need to talk about this. What are you actually doing when you're exercising? Maybe they really are exercising and something else is going on. So again, it's just building that trust with your patients so that they're not afraid to tell you the truth and then knowing when to dig further.
GINA GALAVIZ EISENBERG
Is walking Stefan good enough. Is that good enough for exercise?
STEFAN ARIAS, NP
I caught on to a couple of things that you said there. You walked into the office room. We can start right there with exercise. We can start just by walking. We can start just by walking around the block. That's often where I start with some of my patients. They'll come to me and they'll say hey, I've been sick lately, I haven't been feeling good. That's totally understandable. I know when I'm sick, I've got a three-year old whenever he's bringing home, all the bugs and stuff. Maybe sometimes just walking out to get the mail. Maybe that's where we start, right? Hey, do we feel better a little bit the next day? Now can we walk out to go get the mail and take the trash out? Can we do a couple of different things here? Can we just keep adding? Then, kind of what Olivia was saying, breaking down, are you telling me the truth or not?
One thing that's pretty popular in Texas, hey, do I need to get my boots on? Are we stepping in it a little bit? Your Spidey senses gotta go off. Are you telling me the truth? You're telling me that you're working out, doing all this stuff, but your lab work, your blood pressure, your waistline, everything else kind of says that it's not. It's not a judgmental thing. it's just a, hey, just be honest with us.
GINA GALAVIZ EISENBERG
So, how can we track? Is tracking or keeping a diary or even an app? I mean, what do you suggest in terms of I guess pulling off the band aid and just hitting to it saying, today I'm going to walk and I'm going to write it down on a piece of paper. Is that really helpful?
STEFAN ARIAS, NP
Yeah, I think so. I know that when I look at the way that I track my fitness and the way that I track my exercise is that it can be scaled down to just anything. Just like we kind of said, just starting with walking around the block. You got your watch on or you got that big computer in your pocket, you can just start a time watch on there and say, how long does it take for me to walk around the block? If we want to set an achievable goal, it takes me 15 minutes to walk around the block and I'm just throwing out a number. Next week, maybe it takes me 10 minutes. Okay, cool. Let's try to see if we can get that down to eight minutes. Maybe we don't want to do the time domain thing, maybe we just want to say, hey, we walked around one block, can you go around two? What's something achievable and obtainable that we can kind of set out for? It doesn't have to be some huge, gigantic goal.
GINA GALAVIZ EISENBERG
When people are trying to figure out what they're going to do walking and how long they walk, what is the benefit? I guess people need to go, what am I doing this for? How is it going to really benefit me? How is just walking around the block two or three times going to help me overall?
STEFAN ARIAS, NP
Oh, man, just the basis of improving cardiovascular health, improving gut health. I think there's so many people that come to me and talk to me about, hey, I'm not regular with my bowel movements, or I just feel like I'm not getting everything moving down there. One of the things that I jump in and ask them for is how are you moving? Moving increases blood flow to every single aspect of your body, including your gut. You are going to increase your caloric burn there. You are going to increase your cardiovascular health. You are going to increase your gut health. There's a ton of things that walking and exercising can do for you.
GINA GALAVIZ EISENBERG
Olivia, as a singer, that helps you with breathing and helps you to sing. I guess it just helps you to breathe in general or even sleep. Wouldn't you say that? Will I sleep better if I exercise?
OLIVIA RAHMA, NP
I have patients complaining about fatigue, insomnia, and one of the first things I ask is, well, what are we doing for exercise? It's so easy to say, well, I'm so tired, the last thing I want to do is go for a walk. But the amount of improvement you can feel just by going for a 10-minute walk, getting some fresh air. You'll sleep better, chances are, because you had some physical activity and you will wake up tomorrow, hopefully feeling a little more energized because you had that physical activity.
The other great thing, too, is mental health. Cognitively, are you getting now more blood flow to your brain? You're breathing better when you're exercising; you're getting more oxygen, you feel clearer in the head. Going for a walk even just five minutes is such a good way to clear your mind after work and getting that fresh air. It's gorgeous in Florida right now, I'm sure in Texas it is too. Getting outside at the end of the day with my dogs is the best part of the day and it makes everything bad that could have happened during the day so much better. There's just so many benefits.
GINA GALAVIZ EISENBERG
Well, you are inspiring me and I know you're inspiring our listeners. We're going to continue this discussion in just a moment. I'm Gina Galaviz Eisenberg, along with our co-host nurse practitioner, Olivia Rahma and our special guest nurse practitioner, Stefan Arias with USMD in Fort Worth; you're listening to the award-winning Docs in a Pod.
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GINA GALAVIZ EISENBERG
Thanks so much for staying with us on the award-winning Docs in a pod. I'm Gina Galaviz, Eisenberg, along with our co-host, nurse practitioner, Olivia Rahma, and our guest, nurse practitioner, Stefan Arias with USMD Fort Worth. Let's talk more about tracking fitness.
What do you guys do for fitness? I know you don't have time because Stefan, you have a three-year-old, Olivia, you're working a lot, you have the dogs as well. I mean, y'all have busy lives. What do you do? How do you practice what you preach?
OLIVIA RAHMA, NP
Well, I can go first. My favorite thing to do is, and this may be boring for some people, but I go to the treadmill at the gym. I just mentioned how gorgeous it is outside, but I'm guilty that I like to treadmill. I put it on the incline and I have my iPad set up and I get to read my book, and that's my 45 minutes, maybe a little more sometimes of just me time. I'm getting some walking in and I don't have to worry about anything else and I get to read my book. So, that's my favorite. Sometimes I'll do a spin class or Pilates, but that's most of the time my favorite. And it's as easy as that. It's just walking, so even I am only doing walking, nothing crazy.
GINA GALAVIZ EISENBERG
Stefan, what do you do?
STEFAN ARIAS, NP
Olivia is going to make me seem like a fitness guru or something.
OLIVIA RAHMA, NP
That's okay. That's why you are here.
STEFAN ARIAS, NP
Fitness is paramount to me. It's what I call my adult recess. It's what I call my cheaper than therapy. My absolute favorite thing to do is I do CrossFit. I like to go to my local CrossFit affiliate and just throw down with all my buddies and have a good time. One of the sayings that they have in CrossFit is, it's an hour-long class so we often say it's the best hour of your day. Just getting in there with friends and that group class setting. Just like-minded individuals that have those aspirations of being fit for life. That's kind of the methodology there is that you're training for life, you're training for functional fitness, right? You can probably look up things on the internet, you'll find all types of crazy things with CrossFit, but it really does break down to a basis of functionality. One of the best things that in functional fitness and CrossFit is just a regular old squat. Can you squat down? Can you air-squat? Cause every time you have to squat down to pick up your keys, you have to squat down to get onto the toilet. You got to squat, you got to sit down. Anytime you sit down in your chair, you have to squat down and stand up. So, it's functional fitness, right? I do go on walks with my family and stuff like that.
GINA GALAVIZ EISENBERG
What other things besides squats? Cause that is so functional, that makes total sense, right? But do you pretend like you're using free weights or what do you do as well?
STEFAN ARIAS, NP
Dead lifting, right? Anytime you have to pick anything off the ground you have to have these good body mechanics, right? If you if you go to the grocery store and you've got a two-gallon of milk, how are you going to get it in the door? You might have somebody that can put it in your car for you or carry it out for you but once you're home, how are you going to get that bag of dog food or those canned goods? This isn't something that just stops when we hit the age of 50 or 65 or Medicare age, right? This continues. You still have to deadlift things whenever you're 65. It may not be the weight that you were moving around whenever you were 20 or 30. Just like pressing motions. One of the conversations that I have all the time with my Medicare age folks is, do you want to pick up that grandbaby and hold them up? Do you want to be able to play with your kiddos? Those movements don't stop as we age.
GINA GALAVIZ EISENBERG
10 years ago when my 10-year-old twins were babies, I could carry both of them up until the time they were two or three and two backpacks, no problem. But now, that would be difficult, 10 years later. I find myself trying to do some easy things just for strengthening, but it does change. If you don't use it, you lose it.
STEFAN ARIAS, NP
That's my favorite now that I say that all the time, if you don't use it, you lose it. If you don't use it, you lose it. Exercise is extra. Movement is medicine. Motion is lotion.
GINA GALAVIZ EISENBERG
We're talking losing being able to hold things or move things and pull something.
STEFAN ARIAS, NP
Yes, I tell my patients all the time, everybody wants to look like the cover of the magazine or whatever. But that's not necessarily the goal. That might be somebody's goal but I try to make sure that my patients remember our goals are going to be able to play with our grandkids. Be able to go out with our families. Play golf with your son. Go to the dance recital that your daughter wants you to go to. Walk up to the ball fields, go get up the stairs to get to the baseball game or the t-ball game or whatever. If you're going to go watch Olivia sing, I bet there's some stairs that you've got to get to in the theater somewhere. You want to be able to do that as you get older.
GINA GALAVIZ EISENBERG
That's true, and not to be graphic, but just to go to the bathroom, as you mentioned.
STEFAN ARIAS, NP
It's something that you do, you don't stop doing that when you get to be 65.
GINA GALAVIZ EISENBERG
You kind of go more it seems. How do we keep track of it? What's the best way to not forget to keep track? Is there an app? Everybody has a smartphone, right? Is there a certain app that's just easy to use?
STEFAN ARIAS, NP
Yeah, I think most of the population now has one of those little devices with the fruit on the back in their pocket. There's a ton of apps on it. I tell patients all the time, write down that you went around the block in 15 minutes, write down that it took you this long or you went this many blocks. Most of our smartphones have tracking devices on it. You can get the watches and things. I know I have mine on that tracks everything. I tell patients you can make it as complicated as you want it to be. You can make it as simplified as you want it to be. Whatever works for you is what I want to work for you, and we're going to go from there.
GINA GALAVIZ EISENBERG
Olivia, say I came in to see you and then you're like, I want to see you in three months and I get home, I'm like, I'm going to start exercising. Can you tell that I've been doing what I said I was going to do?
OLIVIA RAHMA, NP
Oh, sure. Honestly, the number one way I can tell is, and this sounds silly, but the patient's mood and just how they look when they come in. The number of times I have a patient who maybe has some really bad labs and their blood pressure was bad, and we had a conversation about exercise and maybe some dietary changes, I can immediately tell when I walk in the room three months later if they look happy. Because if you come in looking happy and excited, I know you want to tell me some good news, and I know you're going to be proud of yourself to tell me. If I walk in and you look kind of like, oh, I'm shy and oh, please don't ask me, I'm going to know that maybe you weren't doing anything. We can tell, and again, no judgment. If I gave you three, four months and you come in and you say, oh, I'm going to be honest, I haven't done anything you told me to do. Okay, let's talk about it again, that's okay. Again, don't be shy, we're not judging. If you feel like you have a provider who is judging you, find somebody else. There's people out there who will not make you feel bad and who will not expect you tomorrow to join a CrossFit gym, maybe down the line but baby steps.
GINA GALAVIZ EISENBERG
Yeah, I would think you're setting yourself for failure if you say, I'm going to go join today and you're not ready yet.
OLIVIA RAHMA, NP
Oh, for sure. You do a week of it and you say, whoa, exercise is not for me. That's not what we want at all.
GINA GALAVIZ EISENBERG
Stefan, what should we do before we try to join CrossFit?
STEFAN ARIAS, NP
I would probably be doing a disservice to my fellow Cross Fitters and my everything else just to say walk in the door, it's a wonderful thing. I'm not here to preach the gospel of CrossFit as I like to say sometimes, but truly, that's one of my favorite things about CrossFit itself, not to make this all about that.
GINA GALAVIZ EISENBERG
Joining a group then I guess, right? It's like that welcoming group of people who want to help you.
STEFAN ARIAS, NP
Yes. Just like Olivia was saying, your mood. When you when you get around other like-minded people that are there for a common goal, it may not be the exact same goal that you have, but they're similar goals, they're common goals. When you get around people that have that same mindset, it makes you want to show up. I know I have a ton of accountability friends. I know for a fact if I don't show up to my regular five o'clock class after clinic, like two or three days in a row, I'm going to get attacked. I'm going to get a phone call. They're going to ask, hey, where have you been? Did you move? Are you okay? Do we need to send the ambulance to your house because you're always here? If you get around people that have that like mine then you'll continually want to go. You'll feel like you owe it to them.
GINA GALAVIZ EISENBERG
That's good advice and we're going to have to end it there. This has been a great discussion. Thank you nurse practitioner Stefan Arias with USMD in Fort Worth for joining us today on the award-winning Docs in a Pod. Thank you to our co-host, nurse practitioner, Olivia Rahma. I'm Gina Galaviz Eisenberg, and in the words of the late Charles Osgood, I'll see you on the radio.
OUTRO
Executive producers for Docs in a Pod are Dan Calderon and Lia Medrano. Associate producer is Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. We welcome your emails with suggestions and comments on this program at radio@wellmed.net. Be sure to listen next week to Docs in a Pod, presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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